探討國人地域性的健康不平等-以乳癌為例

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Title:	探討國人地域性的健康不平等-以乳癌為例
Authors:	林瑋傑;Lin,Wei-Chieh
Contributors:	產業經濟研究所
Keywords:	健康不平等;乳癌;空間模型;醫療資源地理分布
Date:	2016-07-25
Issue Date:	2016-10-13 14:02:29 (UTC+8)
Publisher:	國立中央大學
Abstract:	臺灣長期存在健康不平等的現象，而這現象可能是地區或醫療市場的需求面與供給面因素所造成。因此，本研究旨在分析因為地區或醫療市場的需求面與供給面因素所造成的地域性的健康不平等，並以鄉鎮別的乳癌病患做為研究對象。本研究使用 1999 年、2000 年、2006 年、2013 年的需求面與供給面資料進行實證研究，藉由衛生福利部國民健康署的癌症登記線上互動系統篩選出所需年份的鄉鎮別乳癌死亡率與乳癌發生率當作被解釋變數。本研究考量鄉鎮之間有互相影響的效果存在，因此將使用空間模型解決因空間所產生的偏誤。本研究的實證發現，乳癌死亡率長期而言不存在空間聚集的現象，在需求面因素有老年人口比率與人口密度為正向顯著相關，說明老年人口比率愈高或人口密度愈高的鄉鎮其乳癌死亡率愈高，供給面因素僅有大型醫院的虛擬變數為正向顯著相關，說明有大型醫院的鄉鎮其乳癌發生率愈高。而乳癌發生率長期存在空間聚集的現象，需求面因素有家戶所得與人口密度為正向顯著相關，說明家戶所得愈高或人口密度愈高的鄉鎮其乳癌發生率愈高，供給面因素有每萬人口醫生數與大型醫院的虛擬變數為正向顯著相關，說明醫生數愈多或有大型醫院的鄉鎮其乳癌發生率愈高。本研究從以上實證結果推論臺灣長期而言存在地域性的健康不平等。;There is health inequality in Taiwan over a long period of time because of the demand factors and supply factors. Therefore, This study want to analyze health inequality caused by them. The research subjects are breast cancer patients. We use the demands factors, supply side factors, the breast cancer death rate and the rate of occurrence of breast cancer in towns in 1999, 2000, 2006 and 2010. We consider that there is an effect between towns so that we use spatial models to solve spatial bias. The result is that there isn′t spatial clustering on the breast cancer death rate. On the demand variables, the rate of elderly population and the population density have a significantly positive correlation to breast cancer death rate. On the supply variables, only the dummy variable of large-scaled hospitals has a significantly positive correlation to breast cancer death rate. On the other hand, there is spatial clustering on the rate of occurrence of breast cancer. On the demand variables, the household income and the population density have a significantly positive correlation to the rate of occurrence of breast cancer. On the supply variables, the doctors per ten thousands population and the dummy variable of large-scaled hospitals have a significantly positive correlation to the rate of occurrence of breast cancer. According to the results, we can infer that the geographic health inequality exist in Taiwan over a long period of time.
Appears in Collections:	[Graduate Institute of Industrial Economics] Electronic Thesis & Dissertation

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